5 - WRS & Suprathreshold Testing Flashcards
The measure of threshold for the detection of speech is referred to as the ________
Speech Detection Threshold (SDT or SAT)
The measure of threshold for identification of speech is referred to as the ________
Speech Recognition Threshold
The ability to distinguish words at suprathreshold levels is tested with the _______
Word Recognition Score (WRS)
The WRS is an example of ________ (threshold/suprathreshold) measures
Suprathreshold
What are the two possible response formats for WRS?
Open set: repetition, paper and pencil
Closed set: picture board, computerized response mode
True or False: WRS is synonymous with speech discrimination
False, because it tests the ability to recognize word or speech - it is not testing the ability to discriminate between similar words
The WRS results are calculated as a ______
% correct
Does the WRS use single syllable or double syllable words?
Single syllable: consonant-vowel-consonant
PB (Phonetically balanced) word list
-possible lists include the PB50, CID W-22, and NU-6
Describe the WRS instructions. Is a carrier phrase used?
Yes - instruct the client that you will say a list of words to them, and that they are to repeat each word after you. Guessing is okay.
Begin presentation (Say the word….yard, knees, stove, etc)
How long are PB word lists?
50 words
True or false: during WR Testing, presenting the word with a carrier phrase assists with VU monitoring
True
What do WRS results indicate?
The ability to correctly recognize speech at supra-threshold levels
True or false: WRS results are expressed as % correct at intensity level
E.g. 100% at 80 dB HL
True
Name one method for determining the initial test level for WRS
- 30-40 dB above SRT
- 50 dB HL or 15 dB above SRT, whichever is higher
- Most Comfortable Level (MCL)
What does PI stand for?
Performance Intensity
True or False: PI function shows how the client’s speech recognition performance (in % correct on the y-axis) depends on the intensity of the test materials (x-axis)
True
*PBmax indicates the level in dB HL of the maximum % correct achieved (when dB is raised above this point, there is no improvement)
What is the PBmax for normal hearing listeners?
100% at 35-40 dB re SRT
True or false: regarding PI Function, increasing the intensity of a speech signal will improve the intelligibility and understanding in normal hearing individuals
True
True or false: regarding PI Function, increasing the intensity of a speech signal will improve the intelligibility and understanding in individuals with HL
Not necessarily; degree of improvement in intelligibility is highly variable across individuals with HL
A retrocochlear lesion may be indicated by WRS results that are _____ (better/worse) than expected, and rollover of PI function
Worse
Name one possible reason a person might hear, but not be able to understand
- loss of high frequency unvoiced consonants
- underlying pathophysiology (inner/outer hair cells, 8th nerve)
What is PI Function Rollover
When speech recognition decreases once the dB HL is increased further (beyond PBmax)
A word recognition score of 80% would be considered _______ (Very poor/poor/fair/good/excellent)
Good
A word recognition score of 60% would be considered _______ (Very poor/poor/fair/good/excellent)
Fair
A word recognition score of 91% would be considered _______ (Very poor/poor/fair/good/excellent)
Excellent
A word recognition score of 34% would be considered _______ (Very poor/poor/fair/good/excellent)
Very poor
A word recognition score of 40% would be considered _______ (Very poor/poor/fair/good/excellent)
Poor
Which word lists are more reliable for WRS: 25 or 50?
50 word lists
In the quick version of WRS, testing begins at 80 dB HL or 30 dB SL (whichever is higher.
If WRS > or = 84% with 25 words, then ______ (no further testing is necessary/ increase the level if tolerated) to obtain PBmax
No further testing necessary
Name one reason WRS differences are important
- compare test-retest results
- compare ear differences
What does “SPRINT” stand for?
Speech Recognition Interpretation Chart
What two things can a SPRINT chart be used for?
- within patient comparison of repeated WRS
- within patient agreement between PTA3 and WRS
True or false: the within patient comparison of repeated WRS is based on 25 word list, and can compare WRS tests done at different times, or measured for RE vs LE
True
When comparing WRS with WRS, the first test is measured on the ____ (x/y) axis, and the second test is measured on the ____ (x/y) axis
1st test: x axis
2nd test: y axis (right)
What does the oval region on the SPRINT chart indicate?
No critical difference between 2 WRS results (95% critical differences for 25-word list)
When using the SPRINT chart to compare WRS agreement with PTA, the WRS score is on the ____ (x/y) axis, and the PTA is on the ___ (x/y) axis
WRS score on x axis
PTA on y axis (left)
When comparing WRS and PTA on the SPRINT chart, the shaded area indicates a disproportionately ____ (low/high) score
Low
White area indicates WRS as expected compared to PTA
Grey/shaded area indicates WRS lower than expected compared to PTA
What is one limitation of the WRS?
Validity - does not reflect speech perception in real world
-tested in quiet, low words
Reliability
- number of words
- test procedure (live voice, MCL, fixed SL, multi-level WRS)
Give an example of a WRS modification for pediatric populations
WIPI - closed set test with pictures designed for children
PBK - phonetically balanced kindergarten list
WRS: Summary of Clinical Value
- differential diagnosis
- hearing instrument counselling
- communication ability
Expand on the last two
Counselling
- realistic expectations
- additional technology
Communication Ability
- predict difficulty with communication
Improved WRS at higher levels = potential benefit from amplification
No improved WRS at higher levels = counselling (realistic expectations), alternative strategies (FM systems, aural rehab)
